The importance of gender in health problems.
OBJECTIVE
To investigate gender differences in health problems in general practice.


METHODS
We performed a study using data from the Continuous Morbidity Registration (CMR) Nijmegen. To study the distribution by gender we analysed overall morbidity per 1000 patients years over a period of 10 years. Secondly we calculated the influence of gender by diagnostic rubric. For each diagnosis in the rubric of musculoskeletal disorders, we calculated incidence and sex ratio related to socio econonomic status (SES). We did the same concerning the referral rates for cardiovascular disease (CVD).


RESULTS
Women had significantly more health problems than men, most striking in the age group 25-44 years, due to screening and reproductive health problems. Concerning gender differences related to SES in muskulo skeletal disorders we found the lower the SES the more prevalent is osteoarthritis of the knee in women. The sex ratios in CVD showed men as leading sufferers. Decreasing SES resulted in increasing incidence of CVD and a lower referral rate to the cardiologist in women.


CONCLUSIONS
Sex differences appear in the prevalence of health problems, risk factors and access to medical care. They also can influence the course of diseases. Health problems in men and women also vary according to socio-economic status, meaning that gender is strongly intertwined as risk factor with socio-economic status, ethnicity, and age.
Lagro-Janssen
Toine
T
Department of General Practice, Women's Studies in Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. a.lagro-janssen@hag.umcn.nl
Lo Fo Wong
Sylvie
S
van den Muijsenbergh
Maria
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D012720:Severity of Illness Index; D012737:Sex Factors; D012923:Social Class; D055815:Young Adult